PD-L1、EGFR及TP53在肺肿瘤恶性转变过程中的表达及其意义-东南大学学报医学版

PD-L1、EGFR及TP53在肺肿瘤恶性转变过程中的表达及其意义

单位：1. 上海交通大学医学院附属瑞金医院肿瘤科, 上海 200025;
2. 盐城市第一人民医院病理科, 江苏盐城 224006

分类号：R734.2

出版年·卷·期（页码）：2021·40·第三期（360-365）

摘要：

目的：探索肺癌由腺瘤性增生向进展期肺腺癌恶性转变过程中的分子表达差异和预后特点。方法：（1）收集68例肺肿瘤手术切除的组织样本，进行免疫组化染色，检测程序性死亡配体1（PD-L1）、表皮生长因子受体（EGFR）、TP53在非典型腺瘤性增生（AAH）、原位腺癌（AIS）、微浸润性腺癌（MIA）和浸润性腺癌（IAC）中的表达，并行其相关临床因素分析。（2）分析IAC患者PD-L1的表达与临床病理学特征及临床预后的关系。结果：（1） PD-L1在IAC中高表达，EGFR在AAH、AIS中高表达，TP53在MIA和IAC中高表达，而在AAH和AIS中未表达。在众多因素中，患者的年龄、性别及是否吸烟与肺肿瘤的发生进展有统计学意义（P<0.05），而中性粒细胞与淋巴细胞的比率、血小板与淋巴细胞比率无统计学意义（P>0.05）。（2） PD-L1阳性表达的IAC患者生存率低于PD-L1阴性表达患者（P<0.05）。结论：EGFR可能是肺肿瘤早期发生的分子事件，而TP53是驱动肺肿瘤进展的相对较晚的分子事件。PD-L1的表达与肺腺癌的肿瘤增殖、侵袭性增加及患者生存期缩短有关。

Objective: To explore the molecular expression differences and prognostic characteristics of lung cancer during the malignant transition from adenomatous hyperplasia to advanced lung cancer. Methods: (1) 68 cases of surgically resected lung tumor tissue samples were collected, immunohistochemistry staining was performed, programmed death ligand 1(PD-L1), epidermal growth factor receptor(EGFR), TP53 in atypical adenomatous hyperplasia (AAH), adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA) and invasive adenocarcinoma (IAC) were detected, and analysis of its related clinical factors was done. (2) The correlations of between expressions of PD-L1 in IAC patients and clinical pathological characteristics, clinical prognosis. Results: (1) PD-L1 was highly expressed in IAC, EGFR was highly expressed in AAH and AIS stage, TP53 was highly expressed in MIA and IAC, but not in AAH and AIS. Among the many factors, the patient's age, sex and smoking status were statistically significant (P<0.05), and the ratio of neutrophils to lymphocytes (NLR) and the ratio of platelets to lymphocytes (PLR) was not statistically significant (P>0.05). (2) The survival rate of IAC patients with PD-L1 positive expression was lower than that of patients of PD-L1 negative expressions(P<0.05). Conclusion: EGFR may be an early molecular event in lung cancer, while TP53 is a relatively late molecular event that drives lung tumor progression. The expression of PD-L1 is related to tumor proliferation, increased invasiveness and shortened survival of patients in lung adenocarcinoma.

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